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Dianne Rudolph's picture

By Dianne Rudolph, APRN, GNP-BC, CWOCN, UTHSCSA

Pressure injuries (PIs) are defined by the National Pressure Injury Advisory Panel as “localized damage to the skin and/or underlying soft tissue usually over a bony prominence or related to a medical or other device.” Pressure injuries may present as intact skin or as an open ulcer. These wound may be painful. Pressure injuries occur after exposure to prolonged pressure or as a result of pressure in combination with shear. Other factors may affect soft tissue tolerance, such as nutrition, perfusion, microclimate, the presence of comorbidities, and the condition of the soft tissue.

Cheryl Carver's picture
Fairground

By Cheryl Carver, LPN, WCC, CWCA, DAPWCA, FACCWS

My approach to wound care education with patients, providers, and nursing staff the last 20+ years has always been to make learning fun while emphasizing that wounds are a serious topic. My strong passion drives me to motivate anyone and everyone who wants to learn. If they don’t want to learn, then I’ll figure out the best way to motivate them! Everyone learns differently; however, hands-on training with added fun usually wins. Education should be ongoing and engaging, and it should create fun ways to experience more of those “aha” moments. We want to impact that long-term memory storage! Every care setting has variances, but my blog will provide you with some ideas that you can alter to fit your needs.

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Holly Hovan's picture

By Holly Hovan, MSN, GERO-BC, APRN, CWOCN-AP

Refractory wounds comprise a significant worldwide health problem, affecting 5 to 7 million people per year in the United States alone. Wounds that fail to heal not only impact quality of life but also impose a significant physical, psychosocial, and financial burden. Additionally, individuals with refractory wounds often experience significant morbidity and sometimes mortality. Wound infections and amputations are common in this population, and chronic conditions often exist as well.

Shivani Gupta's picture

By Girisha Maheshwari, Pavan Mujawdiya, and Shivani Gupta

Chronic wounds and their management pose a serious challenge to clinicians worldwide and are one of the major public health challenges faced by developing countries. Worldwide, over 40 million people develop chronic wounds, which adversely affects their quality of life. However, epidemiological studies concerning chronic wounds and their management are limited, especially in developing countries. According to the largest community-based epidemiological study on wounds in India by Gupta et al., the estimated prevalence of chronic and acute wounds is 4.48/1000 and 10.5/1000 in India. This study is more than a decade old, and there is no recent data available in the public domain. The lack of organized wound data makes it difficult to formulate new therapeutic strategies, create effective health care policies, or offer efficacious treatment options. Complex wounds take time to heal, and if they are not identified at the earliest stage, the treatment process may be complicated.

Holly Hovan's picture

By Holly Hovan MSN, APRN, GERO-BC, CWOCN-AP

Wound care and healing require an evidenced-based, interprofessional approach, following standards of care, and treating the whole patient, not just the hole in the patient. Often, wound care clinicians are consulted for recommendations on the treatment of chronic or non-healing wounds, as well as other wound, ostomy, and continence issues. Treating a wound and successfully healing a wound require a holistic approach for the best outcomes.

WoundSource Practice Accelerator's picture

Sharp debridement is by far the fastest way to remove non-viable tissue from a wound bed. This modality must be performed by a licensed skilled practitioner using sharp instruments or tools to remove unhealthy tissue. It is reimbursed by most payers when documentation and medical necessity support its use. There are times when sharp debridement is contraindicated, however. This blog reviews the contraindications and alternatives to sharp debridement.

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WoundSource Practice Accelerator's picture

Approximately 2 million people in the United States are living with limb loss, and this figure is expected to double by 2050. Lower-limb amputation accounts for the vast majority of all amputations, and diabetes—specifically, diabetic foot ulcers (DFUs)—is the leading cause of nontraumatic lower-limb amputations in the US. Although already high, the rate of amputation is increasing.

WoundSource Practice Accelerator's picture

Complex and hard-to-heal chronic wounds impact millions of people globally. In the United States, care for these types of wounds exceeds $25 billion annually. Wound healing naturally progresses through the overlapping phases of hemostasis, inflammation, proliferation, and remodeling. With chronic and complex wounds, the natural biological healing process stalls in the inflammatory phase, thereby preventing both the proliferative phase and further advancement toward wound closure.

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WoundSource Practice Accelerator's picture

Tissue viability is crucial in managing all types of wounds, including surgical wounds, traumatic wounds, pressure injuries, lower-extremity ulcers, and skin tears. Accurate assessment and wound diagnosis are important in treating symptoms and understanding the underlying pathophysiology of the wound.

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WoundSource Practice Accelerator's picture

Collagenase: An enzymes that breaks the peptide bonds in collagen. Collagenases aid in destroying extracellular structures. Collagenase is one of the most frequently used enzymatic debridement agents.

Enzymatic debridement: A topical treatment that uses naturally occurring proteolytic enzymes or proteinases, which break down and remove devitalized tissue by digesting and dissolving this tissue in the wound bed.

Keratotic tissue: Keratotic tissue is the development of horny growths (keratomas). These growths can appear at the edges of wounds and hinder healing. They are removed by debridement to promote healing.

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